ABSTRACT
BACKGROUND: Although it has been reported that papuloerythroderma of Ofuji (PEO) often occurs in association with internal malignancy, the true incidence of malignancy in patients with PEO is unknown. OBJECTIVE AND METHODS: To ascertain the incidence of and relationship with internal malignancy in patients with PEO, 11 patients with PEO diagnosed at our dermatology clinic between September 2005 and June 2011 were retrospectively reviewed. RESULTS: Internal malignancy was found in 6 (54.5%) of the 11 PEO patients, and 5 cases were idiopathic PEO. In the 6 cases with associated malignancy, PEO preceded the malignancies, and the diagnosis of malignancy was made just before or shortly after the diagnosis of PEO, but the malignant process and PEO did not always run a parallel course. CONCLUSIONS: Although the limitations of this study included a relatively small sample size, the present findings show a high incidence of internal malignancy in patients with PEO.
Subject(s)
Glucocorticoids/therapeutic use , Histamine Antagonists/therapeutic use , Neoplasms/complications , PUVA Therapy/methods , Skin Diseases, Papulosquamous/complications , Administration, Topical , Aged , Aged, 80 and over , Combined Modality Therapy/methods , Female , Humans , Incidence , Japan , Male , Neoplasms/pathology , Retrospective Studies , Skin Diseases, Papulosquamous/drug therapyABSTRACT
Itching is a common complaint among patients infected with HIV and may cause significant morbidity and embarrassment. Although idiopathic HIV-pruritus has been described, it is probably less common than was previously thought. In most patients, a careful history and physical examination will show that a dermatosis accounts for their pruritus. Dry skin, seborrheic dermatitis, eczema, psoriasis, pruritic papular eruption, staphylococcal folliculitis and prurigo nodularis are frequently encountered in these patients. These common dermatoses, drug eruptions, several rarer conditions and systemic causes of itching should be excluded before diagnosing idiopathic HIV-pruritus. Treatment should be directed to the underlying skin problem and may be supplemented with sedating antihistamines. Phototherapy is a safe and effective therapeutic modality for many pruritic dermatoses as well as for idiopathic pruritus.
Subject(s)
HIV Infections/complications , Pruritus/virology , Skin Diseases, Infectious/virology , Skin Diseases, Papulosquamous/virology , AIDS-Related Opportunistic Infections/complications , AIDS-Related Opportunistic Infections/diagnosis , AIDS-Related Opportunistic Infections/drug therapy , Humans , Pruritus/diagnosis , Pruritus/etiology , Pruritus/therapy , Skin Diseases, Infectious/complications , Skin Diseases, Infectious/diagnosis , Skin Diseases, Infectious/drug therapy , Skin Diseases, Papulosquamous/complications , Skin Diseases, Papulosquamous/diagnosis , Skin Diseases, Papulosquamous/therapyABSTRACT
Langerhans cell histiocytosis is currently regarded as a reactive proliferative process of Langerhans cells rather than a malignancy. The disease is characterized by Langerhans cell infiltration of skin, lung, bone and other organs. We report a 74-year-old man with Langerhans cell histiocytosis who had generalized hemorrhagic and crusted papules. He also had diabetes insipidus. Because he did not have any severe constitutional symptoms or failure of vital organs, we applied topical PUVA treatment to his skin lesions, which responded well to the therapy. Diabetes insipidus, however, remained, in spite of X ray radiotherapy for the pituitary lesion.